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Doc explains how Coronavirus kills. Jo points out obvious: Stop the Flights or Close the schools, lockdown everyone

Posted By Jo Nova On March 1, 2020 @ 2:38 pm In Medicine,Mortality | Comments Disabled

Fun subject of the day: How Coronavirus kills

No seriously, this is matter-of-fact, youtube-at-its-best, concise, cartoony, and smart.

Think of doctors as Body-Engineers. The problem to solve today Engineer-readers — is how to keep blood supply oxygenated when lungs are highly inflamed, filling with fluid, and the delicate thin membranes of lung tissue can’t cope with the sheer forces of rapid collapse and expansion. As well, if oxygen levels drop, even unconscious patients will breathe involuntarily — out of synch with artificial ventilation machines. The sensation of suffocation creates the urge to breath faster and harder.

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The great news is ICU staff are getting much better at keeping people alive when they get ARDS (Acute Respiratory Distress Syndrome) which can happen with other diseases (like Influenza). Seems, the ICUs can keep 84% alive while they wait for the inflammation to subside and the damage to heal. Though the DIY version at home probably won’t be so effective.

Not enough beds

Obviously, this explains my obsessive interest in the percentage needing ICU care and also the Ro (rate of reproduction or spread). With a shortage of ICU beds, slowing the spread makes a life-and-death difference to state the bleeding obvious. To bore you again: in Australia we have about 1 ICU bed per 12000 people or 2,000 ICU beds nationally.

Check out the Ro epidemiology curve written here Jan 31st: Corona virus and those exponential curves. Note that current estimates of Ro are between 2 and 3, so higher than these (meaning the curve will hit harder, faster and peak higher unless we bring it down through draconian isolation measures). An Ro of 1.8 peaks in just 60 days. Sometime in the last few days a medico in Japan got this through to the guy in charge, which is why with only 200 patients he realized that closing schools was imperative across the whole country. The only way to reduce the R0 to zer0 is to “Stop The Flights”. The next best option (far distant second) are mass lockdowns, closure of factories, schools, offices, etc.

As a reader wrote to me yesterday: It’s not practical to close the borders. My reply: It’s not practical to kill 100,000 people either but one or the other may happen.  Do the maths, WHO estimates 1% CFR (Case Fatality Rate. Let’s be optimistic, call it 0.5%. Deaths in the next six months: Australia, 125,000; Canada, 175,000; New Zealand, 25,000, USA, 1.6m; UK, 300,000. Geddit?

 

Ro epidemiology exponential curve, Graph. Coronavirus potential spread.

Ro, Reproductive curves of  infectious diseases. ResearchGate

Next post: stock up at home. Panic buying is what happens when people wait for the government to tell them to prepare. Think of long lasting food that you will eat anyway, and don’t forget soap, toilet paper, toothpaste, disposable gloves, plastic bags, detergents, medicines (prescriptions). Mail order deliveries are a good option. The less physical shopping you need to do in the next few months, the better. Do it for your country. If you can stay out of the shops, and out of the hospital, that’s going to help the people who can’t.

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